SEC FORM
4
SEC Form 4
| FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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| OMB APPROVAL |
| OMB Number: |
3235-0287 |
| Estimated average burden |
| hours per response: |
0.5 |
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|
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b). |
1. Name and Address of Reporting Person*
| C/O FORRESTER RESEARCH |
| 400 TECHNOLOGY SQUARE |
(Street)
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2. Issuer Name and Ticker or Trading Symbol
FORRESTER RESEARCH INC
[ FORR ]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
|
10% Owner |
| X |
Officer (give title below) |
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Other (specify below) |
| Chief Research Officer |
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3. Date of Earliest Transaction
(Month/Day/Year)
03/31/2005
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4. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
| X |
Form filed by One Reporting Person |
|
Form filed by More than One Reporting Person |
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| Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
|---|
| 1. Title of Security (Instr.
3)
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2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction Code (Instr.
8)
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4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
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5.
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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7. Nature of Indirect Beneficial Ownership (Instr.
4)
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| Code |
V |
Amount |
(A) or (D) |
Price |
| Common Stock |
|
|
|
|
|
|
|
1,689 |
D |
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
|
|---|
| 1. Title of Derivative Security (Instr.
3)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
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5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
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6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
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8. Price of Derivative Security (Instr.
5)
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9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
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10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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11. Nature of Indirect Beneficial Ownership (Instr.
4)
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| Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Incentive Stock Option (right to buy) |
$14.06
|
|
|
|
|
|
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03/31/2006
|
03/30/2015 |
Common Stock |
2,200 |
|
2,200 |
D |
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| Non-Qualified Stock Option (right to buy) |
$14.06
|
|
|
|
|
|
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03/31/2006
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03/30/2015 |
Common Stock |
17,800 |
|
17,800 |
D |
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| Explanation of Responses: |
|
| Remarks: |
|
|
Kimberly A. Maxwell attorney in fact for Daniel Mahoney |
04/04/2005 |
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** Signature of Reporting Person |
Date |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
| * If the form is filed by more than one reporting person,
see
Instruction
4
(b)(v). |
| ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure. |
| Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |
POWER OF ATTORNEY*
I hereby constitute and appoint each of Kimberly
Maxwell and Brittany Roberts signing singly, my true and lawful
attorney-in-fact to:
(1) execute for and on my behalf, in my capacity
as an officer and/or director of Forrester Research, Inc. (the "Company"),
Forms 3, 4 and 5 in accordance with Section 16(a) of the Securities
Exchange Act of 1934 and the rules thereunder;
(2) do and perform any and
all acts for and on my behalf that may be necessary or desirable to
complete and execute any such Form 3, 4 or 5 and timely file such form with
the United States Securities and Exchange Commission and any stock exchange
or similar authority; and
(3) take any other action of any type
whatsoever in connection with the foregoing which, in the opinion of such
attorney-in-fact, may be to my benefit, in my best interest, or that I am
legally required to do, it being understood that the documents executed by
such attorney-in-fact on my behalf pursuant to this Power of Attorney shall
be in such form and shall contain such terms and conditions as such
attorney-in-fact may approve in such attorney-in-fact's discretion.
I
hereby grant to each such attorney-in-fact full power and authority to do
and perform any and every act and thing whatsoever requisite, necessary, or
proper to be done in the exercise of any of the rights and powers herein
granted, as fully to all intents and purposes as I might or could do if
personally present, with full power of substitution or revocation, hereby
ratifying and confirming all that such attorney-in-fact, or such
attorney-in-fact's substitute or substitutes, shall lawfully do or cause to
be done by virtue of this power of attorney and the rights and powers
herein granted. I acknowledge that the attorneys-in-fact, in serving in
such capacity at my request, are not assuming, nor is the Company assuming,
any of my responsibilities to comply with Section 16 of the Securities
Exchange Act of 1934. This Power of Attorney shall remain in full force and
effect until I am no longer required to file Forms 3, 4 and 5 with respect
to my holdings of and transactions in Company securities, unless I earlier
revoke it in a signed writing delivered to the attorneys-in-fact.
IN
WITNESS WHEREOF, I have caused this Power of Attorney to be executed as of
this 1st day of April, 2003.
/s/ Daniel Mahoney
Signature
Daniel Mahoney
Print Name
* Drafter's Note: In filing a Section
16(a) report on behalf of a reporting person, an attorney-in-fact should
indicate after the signature line on the form that he or she is signing as
such. The Power of Attorney should be attached to and filed with the
report, if it has not previously been filed with the Commission. If it is
not practicable to file the Power of Attorney at the time of filing of the
original report, it should be filed as soon as practicable as an amendment
to the original filing. The Power of Attorney need not be filed with
subsequent reports.
